Is this more than a fire drill?

A new Sacramento fire chief comes in, sees the potential cost savings in ambulance staffing and pledges to pursue changes. The firefighters union resists, and nothing happens.

We’ve seen this movie before, but maybe this time the ending will be different—a happier one for taxpayers.

The Fire Department is mostly an ambulance service, responding to more than 45,000 medical calls and only 2,400 fire calls a year. Studies have repeatedly shown that having two firefighters-paramedics in all city ambulances is more expensive than necessary.

In 2015, then-Chief Walt White, backed by City Councilman Jeff Harris, looked at hiring far less costly civilian paramedics or emergency medical technicians. In 2017, the city auditor said staffing ambulances with two civilian paramedics would save more than $4.3 million a year.

Now, new Chief Gary Loesch is pushing a proposal that doesn’t call for civilians, but instead for firefighter-EMTs, who have less medical training but also get paid less than the firefighters now manning ambulances.

He says the savings could eventually be about $10,000 per firefighter, adding up to a couple of million dollars a year.

Of the department’s 17 ambulances, Loesch wants to start with three basic life support units staffed by two firefighter-EMTs; the others would continue to provide advanced life support with one or two firefighter-paramedics. Eventually, five or six would be the cheaper version.

This two-tier system is part of Loesch’s broader plan to match the seriousness of medical calls with the right response—from a nurse-practitioner helping callers by phone to paramedics rushing patients to the emergency room.

“Everyone is concerned about savings,” Loesch told me during a recent interview in his office. But as he also said, he can’t switch the system overnight.

That’s because any changes must be hashed out in contract talks with the city firefighters union, one of the most powerful forces in local politics. A six-month extension—which gave Local 522 a 5 percent raise, in line with other city employee unions—expired in December. Negotiations started January 1 and could be completed in the next couple of months.

A spokesman for Local 522 says it has not seen a detailed proposal on ambulance staffing, but it sounds like a reduction in service to residents.

It didn’t have any comment on how the contract talks are going, but says it has a great relationship with Loesch. “While we will not agree on everything, we agree that our community deserves to have a stronger commitment to Fire and EMS services in Sacramento,” the union said in a statement.

Loesch also says he has a good working relationship with the union. But the chief says he’s also given a clear message: “You’re not going to run the fire department. I’m not going to run 522.”

“I can be a nice guy until I’m not,” he added.

Loesch started in Sacramento last October after 32 years in Philadelphia, most recently as deputy fire commissioner. He says he was brought in from the outside as “fresh eyes” to make the department more diverse and more efficient. We’ll see if he can move the needle on ambulance staffing.

“Change is tough,” he says, but Loesch is talking tough, too: “I’ve committed to die on my sword on this proposal.”